Deciding to improve – when and how — can be three of the most complex decisions made by any business leader. Given the complexities and dynamics within a healthcare setting, in particular, the numerous processes that are functioning at once at any given point present a matrix of variables to be considered. Whether a more effective strategy for improvement needs to be identified, change management strategies determined, targeted clinical quality improvement strategies created or continuous quality improvement methods need to be part of an organization culture, an organization and its leaders must approach the idea of improvement in a conscious and decisive manner.
Healthcare management leaders face many complex issues on a daily basis and can become quickly taxed when analyzing various strategies and methods internally.
Improvement is a priority among a vast number of healthcare services providers and facilities around the globe. Depending on the state of system development or resources, choosing the right improvement method and, when necessary, partners is instrumental in achieving desired goals.
Common and effective improvement initiatives among various countries include clinical quality improvement strategies that target clinical and non-clinical processes simultaneously in a concentrated approach. Most organizations will require assistance of advisory services if this strategy is historically unknown.
Improvement partners can be external or internal to an organization. External partners are traditionally third-party hires by an organization to provide services for a set period of time. Internal partners are often individuals whom have been delegated new and/or increased responsibilities within their current role. The decision to pursue an external or internal partner can be determined based on the needs and dynamics of the organization.
Depending on the state of system development or resources, choosing the right improvement method and, when necessary, partners is instrumental in achieving desired goals.
A list of organizational dynamics is identified in the table below to highlight recommended decisions for organization.
Further to organizational dynamics, the surrounding system infrastructure can often influence the ability to implement improvement initiatives and for staff to withstand ongoing compliance to maintain the achieved improvement.
Less regulated areas often have a more challenging time to sustain improvement; therefore, improvement can be viewed on a scale relative to variables influencing improvement the most (i.e. staff capacity, capital investment, leadership style, historical ability to improve).
Historically and in the context of building a planning structure, less-regulated areas rely on large international NGOs to implement large-scale change.
Medical tourism specifically presents a situation for decisions-makers where the performance of services extends well beyond clinical outcomes for an individual consumer of health or wellness services. Marketing, financial resources, communication of value in combination with performance of services must be well coordinated to produce a sustainable medical tourism product.
Common Barriers to Improvement Include:
• Leadership and/or staff resistance
• Complying collaborative efforts among key stakeholders
• Limited resources
• Poor project management skills
• Leadership and/or staff engagement levels
Common Misconceptions to Improvement Include:
• Effort guarantees positive change
• We do not need to continuously monitor because we know when we improve and/or maintain improvement
• Key performance indicators and analytics require a sophisticated business intelligence platform
• Frontline staff is not concerned with improvement data
• Analytics and monitoring equal increased control and no staff privacy
Marketing, financial resources, communication of value in combination with performance of services must be well coordinated to produce a sustainable medical tourism product.
Tackling these barriers and misconceptions in the beginning of any improvement momentum can be pivotal in improvement success and medical tourism planning. After an initial understanding and implementation of improvement strategies, the idea of accreditation often surfaces among healthcare facility leaders.
The topic of accreditation often eludes many organizations around the globe unless the facility exists in a highly regulated system or a situation where private funding is present. More healthcare organizations are not accredited than accredited around the world by leading international accrediting organizations (i.e. Joint Commission International, Accreditation Canada, Trent Accreditation Scheme).
No industry expert will view accreditation as a poor achievement; however, pursuing accreditation and/or any scale of the recognized frameworks must be accompanied by:
• Understanding that pursuing or achieving accreditation is a one-time solution
• Understanding that deep-rooted management and organizational efficiency issues will require ongoing development and support
• Understanding that achieving accreditation is one measure of success and often the first step into building a culture of quality and safety that requires years of commitment by various levels and generations of staff
When organizations are considering international patient services, patient engagement and patient experience, continuously improving on a scale respective to the needs and dynamics of the organization is paramount in long-term patient retention.
Prior to identifying an external or internal partner, leadership can explore a few options or channels to create positive momentum for improvement:
• Diagnostic evaluation/feasibility analysis (topic or organizational wide)
• Targeted education program for staff skills
• Strategic planning with external partners
• Add or enhance technology infrastructure
• Changes to organizational structure aligned with future key objectives
• Accountable human resource strategies
If improving was easy, many healthcare facilities and businesses would not continuously differentiate themselves from competitors in the market for greater success. When organizations are considering international patient services, patient engagement and patient experience, continuously improving on a scale respective to the needs and dynamics of the organization is paramount in long-term patient retention.
Furthermore, those that do succeed and communicate their service value adequately, the following key messages have been understood by leaders seeking to improve.
• Increasing market share or expanding services often requires operational improvements beyond an enhanced marketing effort
• Incorporating improvement methods in management of international patient services is key to long-term customer retention and new customer channels
• Continuous quality improvement and clinical quality improvement strategies represent the ability to quantify and qualify value
• Appreciating the patient experience as a component of the care continuum and incorporating patient engagement strategies to target service value comprehension, organizations will translate improvement efforts effectively
• Accreditation is one measure of commitment to quality, safety and organizational capacity to commit to continuous improvement
• Improvement partners can be internal or external depending on needs or dynamics of organization
• Majority of organizations (small or large) will gain earlier success when working with an improvement partner that matches culture complexities, an understanding for learning models that match staff capacity and, finally, an understanding of scale in relation to possible improvement.
About the Author
Mary B. Miller, M.HA., CSSBB, is managing partner at MPROVE GLOBAL, Inc. with more than eight years experience in the daily management of healthcare facilities, proven leadership in change management, and the implementation of continuous quality improvement models in various countries.
Miller focuses primarily on the process and structural factors influencing long-term sustainability for improvement models unique and realistic for individual countries or facilities. She holds a Master’s of Health Administration from the University of North Carolina Gillings School of Global Public Health as well as certifications in Lean Six Sigma from Villanova University.